Provider Demographics
NPI:1699703025
Name:DOPPS, BRADLEY EUGENE (CHIROPRACTER)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:EUGENE
Last Name:DOPPS
Suffix:
Gender:M
Credentials:CHIROPRACTER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 W DOUGLAS AVE STE 1040
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3017
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:834 N SOCORA ST STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3279
Practice Address - Country:US
Practice Address - Phone:316-202-0045
Practice Address - Fax:316-440-3741
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC3363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS480903581OtherTAX ID NUMBER